Culture Care Theory

Grace –BSN,RN

Theory of Culture Care Diversity and Universality

- Madeleine M. Leininger

OBJECTIVESOBJECTIVES

Define and understand the concepts of the theory

Discuss and analyze the theory

Discuss the various ways in which Leininger’s theory can be applied to the current nursing practice

Historical Background -EducationHistorical Background -Education

Born July 13,1925 in Sutton, Nebraska, USA Basic nursing education at St. Anthony’s School of Nursing,

Denver, Colorado Bachelor of Science degree in Biological science from Mount

St. Scholastica College, Atchison, Kansas. Master of Science in Psychiatric –Mental health nursing from

The Catholic University of America, Washington ,D.C PhD in Cultural and social anthropology from the University of

Washington, Seattle.(1st professional nurse) Holds honorary doctorates from Benedictine College, the

University of Indianapolis, Indiana and the University of Kuopio, Finland.

George, J. B. (2010). Nursing Theories (6th ed., p. 404-405). Upper Saddle River, NJ: Pearson.

CAREERCAREER Associate Professor and Director of the Graduate Psychiatric

nursing program, College of Nursing and Health, University of Cincinnati.

Professor of nursing & anthropology – University of Colarado Dean of nursing & Lecturer –University of Washington Dean of nursing & Adjunct professor of Anthropology –

University of Utah Professor of nursing,director of the Center for Health Research Wayne state University, Detroit Michigan Professor Emeritus,College of Nursing ,Wayne State University

George, J. B. (2010). Nursing Theories (6th ed., p. 404-405). Upper Saddle River, NJ: Pearson.

OVERVIEWOVERVIEW

• It is a creative outcome of independent thinking, It is not a borrowed theory, but has been developed as a theory to discover care and health needs of diverse cultures.

• It is used by other health related disciplines to provide transcultural care to people from diverse cultures.

• The purpose of the theory was to discover, document, ,know and explain the interdependence of care & culture phenomenon with differences and similarities between among cultures.

• George, J. B. (2010). Nursing Theories (6th ed., p. 404-405). Upper Saddle River, NJ: Pearson.

ASSUMPTIONSASSUMPTIONS

1) Care is the essence of nursing .

2) Culturally based care guides nursing decisions and actions.

3) Transcultural nursing is a humanistic and scientific care discipline

4) Culturally based caring is essential to curing and healing ,There can be no curing without caring , but caring can exist without curing

5) Concepts and processes of care vary transculturally with diversities and some universalities

6)It is essential for wellbeing,health,growth and survival.

Leininger, M., & McFarland, M. R. (2002). Transcultural Nursing: concepts, theories,research&practices (3rd ed., pp. 79). N.p.: McGraw Hill.

Contd…

g. Every human culture has generic care knowledge and practice that varies from professional care and practice.

h. Cultural care values ,beliefs and practices are embedded within world view , language, philosophy, religion, social, political, educational, economical, technological, ethno historical, and environmental context of cultures.

i. Healthy and satisfying culturally based care influences the health of varying clients within their environmental contents.

Leininger, M., & McFarland, M. R. (2002). Transcultural Nursing: concepts, theories,research&practices (3rd ed., pp. 79). N.p.: McGraw Hill.

j. Culturally congruent nursing care can only occur when care values , experiences, or patterns are known and explicitly used for care.

k. Culture care differences and similarities exist between professional and client generic human cultures worlwide.

l. Cultural conflict and Cultural pain exist when there is a lack of cultural care knowledge.

m. The ethnonursing qualitative research method provides an important means to accurately understand emic and etic culture care data.

Leininger, M., & McFarland, M. R. (2002). Transcultural Nursing: concepts, theories,research&practices (3rd ed., pp. 79). N.p.: McGraw Hill.

CONCEPTSCONCEPTS

• CARE - is to render/ help others with the present or incoming needs to facilitate improvement in either human health conditions or even facing death.

• CARING - service, or an act of rendering/ giving care

• CULTURE - is the people’s various ways of adaptation in their everyday life.

• CULTURAL CARE - is an individual's, group or community's different adaptation or learning, acquired and being used to improve and face their everyday way of life, sickness, health and even facing death

• CULTURAL CARE DIVERSITY - is the people’s own understanding in delivering care that are recognized within or in other circle of community.

George, J. B. (2010). Nursing Theories (6th ed., p. 412). Upper Saddle River, NJ: Pearson.

Contd..• CULTURAL CARE UNIVERSALITY - simple/ ordinary care

with almost the same perception or concepts that are seen in many cultures.

• NURSING - is one branch in health profession that is directed to client in scope of care.

• WORLD VIEW - is how the people perceived the world or universe in making their personal understanding of what life is all about.

• CULTURAL & SOCIAL STRUCTURAL DIMENSION - the people/ person's activity in daily living and the influences of their culture, traditions, beliefs, how their political views helps, education and even new technologies, primitive history that affects cultural responses of people within cultural context.

• HEALTH - is a condition of an individual that is culturally recognized and given importance.

Contd..• CULTURAL CARE PRESERVATION & MAINTENANCE -

rendering care and giving importance to peoples' culture, belief and respecting their values and practices regarding health care status and scope of health care understanding.

• CULTURAL ACCOMODATION & NEGOTIATION - offering other alternative ways of rendering health care that is acceptable to people and community for a better result that is shared by the health care provider and health care receiver.

• CULTURE CARE REPATTERNING

It helps the client to reorder, change or modify their lifestyles for new , different and beneficial health outcome.

• George, J. B. (2010). Nursing Theories (6th ed., p. 415). Upper Saddle River, NJ: Pearson.

METAPARADIGMMETAPARADIGM

Person

•Concept of person is not culturally appropriate in many cultures , person is not a central or dominant concept in a culture ,she liked the term human beings to person. A focus on the individual should occur only if it is appropriate to the culture in which care is being given.

•George, J. B. (2010). Nursing Theories (6th ed., p. 412). Upper Saddle River, NJ: Pearson.

Health

Leininger speaks of health systems, health care practices, changing health patterns, health promotion and health maintenance. The emphasis is on the need for nurses to have knowledge that is specific to the culture in which nursing is being practiced.

Health is both universal and diverse.

• George, J. B. (2010). Nursing Theories (6th ed., p. 412). Upper Saddle River, NJ: Pearson.

EnvironmentEnvironment

•Leininger speaks to social structure and worldview rather than society ,she defines environment as the totality of geophysical situations

•George, J. B. (2010). Nursing Theories (6th ed., p. 412). Upper Saddle River, NJ: Pearson.

Nursing• Leininger defines nursing as a profession which has a

societal mandate to serve people and as a discipline is expected to discover, develop, and use knowledge distinctive to nursing focus on human care and caring.

i. Culture care preservation / maintenance

ii. Culture care accommodation/ negotiation

iii. Culture care repatterning / restructuring

Leininger, M., & McFarland, M. R. (2002). Transcultural Nursing: concepts, theories,research&practices (3rd ed., pp. 570). N.p.: McGraw Hill.

Sunrise Model/EnablerSunrise Model/Enabler

Leininger, M., & McFarland, M. R. (2002). Transcultural Nursing: concepts, theories,research&practices (3rd ed., pp. 79-82). N.p.: McGraw Hill.

ANALYSIS

There are 444 Scholarly Journals(peer reviewed ) for “Culture Care theory” from 1998 – 2013 in CINHAL

There are 97 Academic journals in English from 1990 – 2014 for “Culture Care theory” in MEDLINE

There are 31587 Scholarly Journals for “Culture Care theory” which are peer reviewed in ProQuest Nursing & Allied Health Source.

RESEARCHRESEARCH

• Bridging generic and professional care practices for Muslim patients through use of Leininger’s culture care modes

• It is also used in Prenatal care among Mexican women, Canadian women, Euro American women, it was also used in elders from different parts of the world.

STRENGTHS & LIMITATIONSSTRENGTHS & LIMITATIONSSTRENGTHS

•Recognition of the importance of culture and its influence on everything .

•This theory was tested by a number of people in a variety of settings and cultures.

•The Sunrise enabler provides guidance for the areas in which information is needed.

WEAKNESS/ LIMITATION•Limited graduate nurses are academically prepared for culture care nursing.

George, J. B. (2010). Nursing Theories (6th ed., p. 423). Upper Saddle River, NJ: Pearson.

LEVELS OF PREVENTIONLEVELS OF PREVENTION

• Primary Prevention

• Secondary Prevention

• Tertiary Prevention

EVALUATIONEVALUATION

• Historical Context ?She developed ideas on culture and caring in the 1950’s but

labelled her thinking into theory in 1985.

• Basic concepts and relationships ?All her concepts are are demonstrated in the Sunrise Enabler

model.

• Phenomenon of concern to nursing ? Culture, care and culture care

George, J. B. (2010). Nursing Theories (6th ed., p. 419 - 423). Upper Saddle River, NJ: Pearson.

• Whom does the theory apply?

It applies to anyone in any situation, especially for nurses as they need to be culturally appropriate.

• Methods to test the theory?

Qualitative research

• Favorable outcome?

This theory does not giver specific direction for nursing actions. But it provides directions on how to learn about

culture of another

George, J. B. (2010). Nursing Theories (6th ed., p. 419 - 423). Upper Saddle River, NJ: Pearson.

• Contagious??

This theory is highly contagious as it is universally applicable and widely presented.

George, J. B. (2010). Nursing Theories (6th ed., p. 419 - 423). Upper Saddle River, NJ: Pearson.

REFERENCESREFERENCES

• Alamah, H. W. (2008, April). Bridging generic and professional care practices for Muslim patients through use of Leininger’s culture care modes. Contemporary Nurse, 28(1-2), 83-97. Retrieved October 28, 2014, from CINAHL.

• George, J. B. (2010). Nursing Theories (6th ed., p. 404 - 425). Upper Saddle River, NJ: Pearson.

• Leininger, M., & McFarland, M. R. (2002). Transcultural Nursing: concepts, theories, research & practices (3rd ed). N.p.: McGraw Hill.